Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.77 / $71.77 / $71.77	Facility	26	$71.77	$71.77	$71.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $178.79 / $475.00 / $598.50	Professional		$178.79	$475.00	$598.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.20 / $105.61 / $358.20	Professional	26	$66.20	$105.61	$358.20
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $89.40 / $89.40 / $104.29	Professional	52	$89.40	$89.40	$104.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $116.30 / $335.00 / $1,172.70	Professional	TC	$116.30	$335.00	$1,172.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $371.74 / $454.56 / $568.20	Professional		$371.74	$454.56	$568.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $130.05 / $159.02 / $198.77	Professional	26	$130.05	$159.02	$198.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $241.70 / $295.54 / $369.43	Professional	TC	$241.70	$295.54	$369.43
Medica Facility/Professional Professional Modifier Low / Median / High Price $262.58 / $404.82 / $3,145.84	Professional		$262.58	$404.82	$3,145.84
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $89.18 / $137.49 / $577.89	Professional	26	$89.18	$137.49	$577.89
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $173.40 / $267.33 / $2,772.01	Professional	TC	$173.40	$267.33	$2,772.01
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $234.49 / $234.49 / $234.49	Facility	26	$234.49	$234.49	$234.49
Midlands Facility/Professional Professional Modifier Low / Median / High Price $414.17 / $493.22 / $938.80	Professional		$414.17	$493.22	$938.80
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $266.87 / $357.70 / $440.30	Professional		$266.87	$357.70	$440.30
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $90.53 / $118.59 / $135.19	Professional	26	$90.53	$118.59	$135.19
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $176.34 / $229.25 / $290.94	Professional	TC	$176.34	$229.25	$290.94
United Facility/Professional Professional Modifier Low / Median / High Price $235.68 / $404.82 / $545.40	Professional		$235.68	$404.82	$545.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $83.48 / $133.78 / $160.47	Professional	26	$83.48	$133.78	$160.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $152.19 / $267.33 / $327.94	Professional	TC	$152.19	$267.33	$327.94
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $433.30 / $509.70 / $509.70	Professional		$433.30	$509.70	$509.70
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $155.60 / $183.00 / $183.00	Professional	26	$155.60	$183.00	$183.00
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $277.70 / $326.70 / $326.70	Professional	TC	$277.70	$326.70	$326.70